County Durham and Darlington NHS Foundation Trust places cookies on your computer to improve our website. These cookies don't collect information that identifies a visitor and are all anonymous.� They are used to measure its performance and to provide enhancements to you while using the site. To find out more about the cookies we use, see our privacy policy. Close

Section 5 - Information for GPs

Information for GPs

Welcome to the County Durham and Darlington Foundation Trust's Stammering Therapy webpage. This section contains information specifically for GPs as you are the main referrers to our service for adults who stammer.

Assessment and therapy for stammering is provided from age 16+. It is available at all 5 hospital sites and delivered by SLTs who specialise in Stammering Therapy.

How to refer a patient

You can refer by writing to the Adult SALT Team at the following address.

Central Appointments Bureau

Speech & Language Therapy

Bishop Auckland General Hospital

Cockton Hill Road

Bishop Auckland

County Durham

DL14 6AD

Telephone: 01388 455200

You can also inform your patients that they can self-refer, either by telephone on the above number or by emailing: cdda-tr.centralbooking@nhs.net.

Who to refer

Fluency disorders present in various forms. Some people will have a more obvious overt stammer with evidence of struggle behaviour and speech blocking. Struggle behaviour refers to the person who stammers reacting physically or emotionally to their moment of stammering; speech blocking is where the mouth is positioned to say a word, but no sound comes out, and there is visible tension. Other people who stammer may be appear to be completely fluent with little or no evidence of struggle behaviour or dysfluency in their speech. This is a covert/interiorised stammer and is the result of high levels of word avoidance and frequently high anxiety. Sometimes these people can experience difficulty getting referred for therapy as their difficulty is not obvious. Some people may have a mix of overt and covert symptoms.

People may also begin to stammer later in life due to neurological problems - neurogenic stammer, or sometimes in association with anxiety - psychogenic stammer.

In all cases the stammer itself is just the tip of the iceberg. Many people who stammer report significant distress and frustration with the negative impact the stammer has on their ability to lead a full life.

How to respond to a patient who asks for a referral

  1. When you have discussed the stammering problem with your patient and agreed to make the referral to SALT, we would be grateful if you could direct them to the SALT Stammering webpage: /our-services/community-health-services/adult-speech-and-language-therapy/stammering.aspx.
  2. This will inform the patient about our service in advance of them receiving an appointment. It will help reduce anxiety by providing information of what they can expect when they come for assessment and therapy. The webpage is designed to be an evidence based educational resource enabling patients to access accurate and realistic benefits of stammering therapy.

 

How to respond to a patient who is stammering but not acknowledging it

  1. Bring up the subject of stammering with them.
  2. Ask if they are aware of the Adult SALT service for stammering.
    • If they are not, provide them with the address / relevant search terms (typing "CDDFT Adult SALT stammering" into a search engine will ensure they find this page).
  3. Ask if they wish to seek a referral.
    • If they do, inform them referral is straightforward, and that you can refer them or they can refer themselves using the information provided on the website.
    • If they do not wish to be referred, reiterate this website as an educational resource, which also contains links to other websites and support groups.

We appreciate that this conversation may not be easy, but the majority of our clients have told us they were pleased that their GP broached the topic with them.

'As I was very, very nervous, I must have been the worst patient ever and they were brilliant with me and I can't thank them enough - could you please pass on my sincere thanks.'

Patient, Hysteroscopy Unit, Chester-le-Street Community Hospital